Original Article

Supportive Care in Cancer

, Volume 18, Issue 6, pp 667-677

First online:

Nutritional support for head and neck cancer patients receiving radiotherapy: a systematic review

  • Shashank GargAffiliated withSchulich School of Medicine and Dentistry, University of Western Ontario
  • , John YooAffiliated withSchulich School of Medicine and Dentistry, University of Western OntarioDepartment of Otolaryngology - Head and Neck Surgery, University of Western OntarioLondon Health Sciences Centre
  • , Eric WinquistAffiliated withSchulich School of Medicine and Dentistry, University of Western OntarioDepartment of Oncology, University of Western OntarioLondon Health Sciences Centre Email author 

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Abstract

Purpose

Squamous cell carcinoma of the head and neck (HNSCC) is associated with weight loss before, during, and after treatment with radiotherapy (RT). This systematic review addressed the question “Which interventions aimed at optimizing nutrition are of benefit to HNSCC patients receiving RT?”

Methods

Randomized controlled trials (RCTs) studying interventions directed at nutritional support of adult patients with HNSCC receiving RT with or without chemotherapy were eligible. RCTs studying prophylaxis of acute mucositis, perioperative nutrition, or palliative and non-HNSCC populations were excluded. A comprehensive literature search was done and meta-analyses planned.

Results

Ten unique RCTs were identified (n = 585). All randomized less than 50 patients per trial arm. Five trials studied dietary counseling and/or nutritional supplements, four studied drug interventions, and one studied prophylactic enteral tube feeding. Nutritional status appeared to be maintained or improved with dietary counseling, megestrol acetate, and prophylactic enteral tube feeding.

Conclusions

Data from RCTs supporting the use of interventions to optimize nutrition in HNSCC patients receiving RT are limited in both quantity and quality. Potentially effective interventions have not been tested comparatively or in combination, and few patients receiving chemoradiotherapy were studied. Further research in this area is a priority.

Keywords

Nutrition Radiotherapy Head and neck neoplasms Megestrol acetate Enteral feeding